METHODS AND INDICATORS TO VALIDATE COUNTRY REDUCTIONS IN INCIDENCE OF HEPATITIS C VIRUS INFECTION TO ELIMINATION LEVELS SET BY THE WORLD HEALTH ORGANIZATION

Adelina A Artenie*, Niklas Luhmann, Aaron G Lim, Hannah Fraser, Zoe D Ward, Jack Stone, Louis W MacGregor, Josephine G Walker, Adam J W Trickey, Lara K Marquez, Laith J Abu-Raddad, Houssein H. Ayoub, Nick Walsh, Matt Hickman, Natasha Martin, Philippa J Easterbrook, Peter T Vickerman

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

One of the main goals of the 2016 Global Health Sector Strategy on viral hepatitis is the elimination of hepatitis C virus (HCV) as a public health problem by 2030, defined as an 80% reduction in incidence and 65% reduction in mortality relative to 2015. Although monitoring HCV incidence is key to validating HCV elimination, it can be resource-intensive for countries to measure this metric using the gold-standard method, which involves prospective HCV re-testing of people at risk. Additionally, few countries have collected quality data in 2015 to document an 80% decrease by 2030. In this paper, we first review different methods by which HCV incidence can be monitored and discuss their resource implications and applicability to various populations. Second, using mathematical models developed for various global settings, we assess whether trends in HCV chronic or antibody prevalence or scale-up levels for HCV testing, treatment and preventative interventions can be used as reliable alternative indicators to validate the HCV incidence target. Third, we discuss the advantages and disadvantages of an absolute HCV incidence target and suggest a suitable threshold. We then propose three options that countries can use to validate the HCV incidence target, depending on the available surveillance infrastructure.

Original languageEnglish
JournalThe Lancet Gastroenterology and Hepatology
Publication statusAccepted/In press - 17 Aug 2021

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